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The aftermath of severe COVID-19 frequently involves considerable cardiopulmonary damage, necessitating rehabilitation. This study aimed to evaluate the impact of COVID-19 on cardiopulmonary health and assess the effectiveness of various rehabilitative interventions. Conducted between September 2021 and September 2022, this prospective study included patients who had been diagnosed with severe COVID-19 and admitted at the “Victor Babes” Infectious Diseases and Pulmonology Hospital, Timisoara, Romania. The patients were stratified into low- and high-intensity rehabilitation groups. The rehabilitation protocols were individually tailored, and the patient recovery was closely monitored over a 3-month period. Our cohort comprised 84 patients, with a mean age of 56.3 years for the low-intensity group (n = 42) and 53.1 years for the high-intensity group (n = 42). Both groups showed significant improvements in the lung injury area, need for oxygen supplementation, ejection fraction, systolic pulmonary artery pressure, and forced vital capacity. Additionally, considerable enhancements were observed in maximal voluntary ventilation, FEV1, FEV1/FVC ratio, peak expiratory flow, and forced expiratory flow at 25–75%. The work intensity also demonstrated substantial improvements from the initial testing to the 3-month mark in both groups. This study provides evidence that personalized, targeted rehabilitation strategies can improve long-term cardiopulmonary health in patients recovering from severe COVID-19, proving both low-intensity and high-intensity training as sufficient to improve heart and lung function if performed correctly and over a relatively short duration of 3 months. The study findings underscore the importance of implementing comprehensive cardiopulmonary rehabilitation protocols in the care of post-COVID-19 patients and highlight the value of stratified rehabilitation intensity based on individual patient dynamics and recovery features.

Background and Aims: Recent studies have brought evidence on the connection between excess weight and suboptimal glycemic control for Diabetes Mellitus (DM) patients. The aim of this study was to evaluate the association between increased Body Mass Index (BMI) and the likelihood of having suboptimal glycemic control in patients with Type 1 and Type 2 Diabetes Mellitus. Materials and Methods: A case-control study was conducted on 662 patients suffering from Diabetes Mellitus and statistical analysis was performed in order obtain evidence associating BMI and poor glycaemic control. We defined as increased BMI, values >25 kg/m2 and a hemoglobin A1c (HbA1c) value >7% reflected suboptimal glycemic control. Results: 559 (84%) patients had HbA1c >7%. 550 (83 %) patients had a BMI >25 kg/m2. In case of HbA1c >7%, a BMI >25 kg/m2 was found in a number of 457 patients (82 %), whereas a normal BMI was present in 102 (18%) patients. For the HbA1c25 kg/m2 was 93 (90%) and a normal BMI was present in 10 (10%) patients. BMI >25 kg/m2 was not associated with a higher probability of having above-target HbA1c values compared to patients with target HbA1c (OR 0.48, 95% CI: 0.24 to 0.95), with a statistically significant p 25 kg/m2 was significantly higher than the number of patients with a BMI < 25 kg/m2, a BMI above target was not associated with greater odds of having HbA1c higher than the standard 7% level, compared to individuals with normal HbA1c levels. The results emphasize that a multitude of factors are involved in the process of achieving a targeted glycemic control and a stepped-care approach should be considered for optimum management of Diabetes Mellitus.

AIMS: The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). METHODS AND RESULTS: Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis >50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables+29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). CONCLUSION: The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.

Gabriela Mut-Vitcu,1 Bogdan Timar,2 Romulus Timar,1 Cristian Oancea,3 Ioan Cosmin Citu4 1Second Department of Internal Medicine, 2Department of Functional Sciences, 3Department of Infectious Diseases, 4Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Purpose: To evaluate the prevalence of depression and its impact on the quality of diabetes-related self-care activities in elderly patients with type 2 diabetes. Patients and methods: In this cross-sectional study, 184 patients with type 2 diabetes were enrolled. Depression was evaluated using Patient Health Questionnaire-9 while the quality of diabetes-related self-care activities was assessed using the Summary of Diabetes-Related Self Care Activities Questionnaire. Results: In our study group, 53.3% of the patients had moderate depression, 17.9% had severe depression, and 28.8% had no depression symptoms. Patient’s age (P=0.024), presence of diabetic neuropathy (P

Using PET, we measured the whole-body distribution of 11C-(+)-PHNO (11C-(+)-4-propyl-9-hydroxynaphthoxazine), a D2/3 agonist, as a function of time in adult subjects in order to determine the internal radiation dose. Methods: PET whole-body data were acquired after the injection of 11C-(+)-PHNO (∼360 MBq) in 6 healthy subjects (3 male and 3 female). The PET acquisition duration was a maximum of 112.5 min, and 9 discrete time frames were obtained. After reconstruction of the emission data, 6 organs were identified in the images as exhibiting uptake above background levels. Regions of interest were delineated on these organs, and time–activity curves were generated. The time–activity curve data were corrected for the injected activity, specific organ density, and volume, from which normalized accumulated activities (previously known as residence times) were calculated. The normalized accumulated activities were then used with the software code OLINDA/EXM 1.1 to calculate the internal doses for the standard adult male and female models. Results: The mean effective dose was estimated to be 4.5 ± 0.3 μSv/MBq when all subjects were included and the male model was applied for the dosimetry calculation, and the mean effective dose was estimated to be 5.2 ± 0.2 μSv/MBq when the females were considered separately and the female model was applied for the calculation. The organ receiving the highest dose was the liver (17.9 ± 3.9 μSv/MBq), followed by the kidneys (14.3 ± 3.6 μSv/MBq) and the urinary bladder wall (13.5 ± 3.7 μSv/MBq). Conclusion: The estimated radiation doses for 11C-(+)-PHNO are similar to those reported for other radiotracers labeled with 11C. 11C-(+)-PHNO may be used for multiple PET scans in the same subject and remain within regulatory guidelines.

We measured the whole-body distribution of IV-injected [11C]GSK215083, a new 5-HT6 antagonist PET tracer, as a function of time in adult subjects, in order to determine the radiation exposure. After injection with a single bolus of [11C]GSK215083 (range 330–367 MBq; mean 346 MBq), PET emission data were acquired for approximately 120 min in six subjects (three males and three females). Five organs were identified as exhibiting uptake above background. For these, regions of interest were delineated on emission images, and time–activity curves (TAC) generated. Residence times were calculated as the area under the curve of the TAC, normalized to injected activities and standard values of organ volumes. Dosimetry calculations were then performed using the computer program OLINDA/EXM 1.0. The mean effective dose averaged over both males and females (±standard deviation) was estimated to be 7.7 ± 1.0 μSv/MBq (male 7.0 ± 0.4; female 8.5 ± 0.6). For the effective dose equivalent, the corresponding values are 7.8 ± 1.2 μSv/MBq (male 6.8 ± 0.5; female 8.9 ± 0.1). The organ receiving the highest dose was the lung, with an average equivalent dose of 25.6 ± 6.9 μSv/MBq (male 20.8 ± 5.6; female 30.4 ± 4.4). The estimated radiation dose for [11C]GSK215083 is consistent with those for other neuroreceptor ligands labeled with carbon-11. The somewhat higher dose estimate for females compared to males may reflect the difference in observed residence times and representative differences in the male and female phantoms used for dosimetry calculations. Based on conventionally accepted dose limits, [11C]GSK215083 may be used for multiple PET scans in the same subject.

This article describes the kinetic modeling of [18F]-FEPPA binding to translocator protein 18 kDa in the human brain using high-resolution research tomograph (HRRT) positron emission tomography. Positron emission tomography scans were performed in 12 healthy volunteers for 180 minutes. A two-tissue compartment model (2-CM) provided, with no exception, better fits to the data than a one-tissue model. Estimates of total distribution volume ( VT), specific distribution volume ( VS), and binding potential ( BPND) demonstrated very good identifiability (based on coefficient of variation ( COV)) for all the regions of interest (ROIs) in the gray matter ( COV VT < 7%, COV VS < 8%, COV BPND < 11%). Reduction of the length of the scan to 2 hours is feasible as VS and VT showed only a small bias (6% and 7.5%, respectively). Monte Carlo simulations showed that, even under conditions of a 500% increase in specific binding, the identifiability of VT and VS was still very good with COVT values obtained from an unconstrained 2-CM with data from a 2-hour scan support the use of VT as an appropriate and feasible outcome measure for [18F]-FEPPA.

The D(2) receptors exist in either the high‐ or low‐affinity state with respect to agonists, and while agonists bind preferentially to the high‐affinity state, antagonists do not distinguish between the two states. [(11)C]‐(+)‐PHNO is a PET D(2) agonist radioligand and therefore provides a preferential measure of the D(2) (high) receptors. In contrast, [(11)C]raclopride is an antagonist radioligand and thus binds with equal affinity to the D(2) high‐ and low‐affinity states. The aim was to compare the brain uptake, distribution and binding characteristics between [(11)C]‐(+)‐PHNO and [(11)C]raclopride in volunteers using a within‐subject design. Both radioligands accumulated in brain areas rich in D(2)/D(3)‐receptors. However, [(11)C]‐(+)‐PHNO showed preferential uptake in the ventral striatum and globus pallidus, while [(11)C]raclopride showed preferential uptake in the dorsal striatum. Mean binding potentials were higher in the putamen (4.3 vs. 2.8) and caudate (3.4 vs 2.1) for [(11)C]raclopride, equal in the ventral‐striatum (3.4 vs. 3.3), and higher in the globus pallidus for [(11)C]‐(+)‐PHNO (1.8 vs. 3.3). Moreover [(11)C]‐(+)‐PHNO kinetics in the globus pallidus showed a slower washout than other regions. One explanation for the preferential binding of [(11)C]‐(+)‐PHNO in the globus pallidus and ventral‐striatum could be the presence of a greater proportion of high‐ vs. low‐affinity receptors in these areas. Alternatively, the observed distribution could also be explained by a preferential binding of D(3)‐over‐D(2) with [(11)C]‐(+)‐PHNO. This differential binding of agonist vs. antagonist radioligand, especially in the critically important region of the limbic striatum/pallidum, offers new avenues to investigate the role of the dopamine system in health and disease. Hum Brain Mapp 2008. © 2007 Wiley‐Liss, Inc.

The present study focuses on the application of a therapeutic strategy in patients with chronic severe lower limb ischaemia using a plasmid vector encoding the vascular endothelial growth factor (phVEGF165). It has been shown that VEGF promotes neo-vascularization and blood vessel network formation and thus might have the ability to improve blood-flow at the level of the affected limbs. However, little information is available regarding the necessary level of expression of VEGF and its possible related adverse effects. We have subcloned VEGF 165 isoform into pCMV-Script expression vector (Stratagene) under the control of the CMV promoter. Three patients with chronic ischaemia of the lower limb, considered as not suitable for surgical re-vascularization, received intramuscular injection with 0.5 ml saline solution containing 1011 copies of VEGF 165 plasmid. The clinical evolution has been monitored by angiography and estimated by walking time on the rolling carpet (Gardner protocol). Two months after therapy, all three patients showed complete relief of rest pain, improvement of ischaemic ulcer lesions and increased walking distance on the rolling carpet most probably due to appearance of newly formed collateral vessels.

Predicting rewards and avoiding aversive conditions is essential for survival. Recent studies using computational models of reward prediction implicate the ventral striatum in appetitive rewards. Whether the same system mediates an organism's response to aversive conditions is unclear. We examined the question using fMRI blood oxygen level‐dependent measurements while healthy volunteers were conditioned using appetitive and aversive stimuli. The temporal difference learning algorithm was used to estimate reward prediction error. Activations in the ventral striatum were robustly correlated with prediction error, regardless of the valence of the stimuli, suggesting that the ventral striatum processes salience prediction error. In contrast, the orbitofrontal cortex and anterior insula coded for the differential valence of appetitive/aversive stimuli. Given its location at the interface of limbic and motor regions, the ventral striatum may be critical in learning about motivationally salient stimuli, regardless of valence, and using that information to bias selection of actions. Inc. Hum Brain Mapp, 2007. © 2006 Wiley‐Liss, Inc.

The shapes of Dicke-narrowed spectral lines in the fundamental P -branch of CO in Ar are studied by comparing high-resolution measurements and theoretical calculations. The measured spectra were recorded at temperatures between 214 and 324 K, and at pressures between 0.025 and 1 atm. The calculations are based on solving a transport/relaxation equation for the appropriate off-diagonal element of the density matrix; they use a realistic intermolecular potential to determine the speed-dependent collisional broadening, and a rigid sphere potential to determine the Dicke narrowing. It is found that the calculations can reproduce the measured spectra within the experimental noise under all conditions, but that the magnitude of the Dicke narrowing in the measured spectra is 70–90% less than predicted from the mass diffusion constant. A revised view of the collision operator resolves the discrepancy in principle, and leads to a better understanding of the line shape problem in general.

The collisional shifts and widths of several P -branch spectral lines in the fundamental band of CO–Ar have been measured at temperatures between 214 and 324 K and pressures between 0.025 and 1 atm. The widths have been determined using a line shape model based on the solution of the transport/relaxation equation for the appropriate off-diagonal element of the density matrix. The model uses a realistic molecular potential energy surface to calculate the speed dependence of the collisional broadening, and a rigid sphere potential to calculate the translational motion. It is found that both the shifting and broadening coefficients follow a power law dependence on the temperature. Additionally, it is demonstrated that studies have tended to overestimate the accuracy of collisional widths when the line shape model used to obtain the widths involves multiple fitted line shape parameters or fails to fit the measured spectra within the experimental noise.